Compassionate Care: The Impact of Complex PTSD in Romantic Relationships

“My partner has been diagnosed with Complex Post-Traumatic Stress Disorder (c-PTSD) and I’m not sure how best to support them”.

You have most likely heard of Post-Traumatic Stress Disorder (PTSD) which is an anxiety disorder that can occur after a traumatic event or a number of traumatic events. However, it is important to know that c-PTSD is also caused by traumas to someone’s life.

What is Complex PTSD?

Complex Post-Traumatic Stress Disorder (c-PTSD) is a psychological condition that develops from prolonged exposure to a series of traumatic events, usually in a situation where the individual may feel trapped, ignored, rejected, unimportant, not good enough, unlovable, unwanted, and helpless. Unlike standard PTSD, which is often be caused by a single traumatic event, c-PTSD may be caused by repeated traumas, a series of emotional or relational traumas, such as ongoing abuse or emotional neglect. This prolonged, ongoing trauma picture of c-PTSD is most often caused in childhood or teenhood and can significantly impact a person's view of themselves quite early on in their life, and thus can later affect the adult’s ability to form and maintain healthy relationships in later life.

The child or teen’s brain cannot fully comprehend the reasons behind the parent or caregiver’s inability to meet their basic emotional or physical needs and may internalise this to mean that they themselves are bad, stupid, not good enough, unlovable, unsafe, or unworthy. The child or teen’s brain may not be able to understand why they receive affection and support sometimes, but not other times. This result of unmet core fundamental needs as a child or teen is that they grow into adults who continue to have this chronic fear that they may not get the love or emotional support they need when they need it. This uncertainty and doubt obviously affects the person’s emotional and psychological development, especially in later adult relationships.

Understanding Complex PTSD

Research shows that c-PTSD can impact your partner’s life in many ways:

o   Low or poor self-image

o   Distrust of others

o   Attachment issues (insecure attachment style)

o   Difficulty with healthy emotion regulation (anger, distress or depression)

o   Impulsive behaviours

o   Difficulty with emotional intimacy or closeness

o   Fear of abandonment

o   Sensitive to criticism

o   Reduced ability to tolerate stress

o   Poor memory

o   Changes to personality traits

o   Flashbacks/triggers/sensory overwhelm

o   Increase risk of substance use

o   Heightened hypervigilance around other people

o   Unhealthy coping skills

c-PTSD affects a person’s self-identity, self-worth, sense of relationship safety, interpersonal skills, trust building and boundary setting skills. The symptoms of c-PTSD can tend to be both chronic and broad, with a wider range of symptoms than PTSD and impacts a partner’s self-identity and view of themselves.

How Can I Help My Partner?

Learn Your Partners Coping Techniques

Your partner may feel validated, loved, and supported if you enquire as to what tips, skills or techniques you could remind them to use during difficult times. It may help you to feel effective and confident if you can find ways to support your partner when they are having a challenging moment such as deep breathing exercises, grounding activity or prompting them to have a walk together.

Be Consistent and Reliable

It may make it easier for your partner to trust you and build a secure attachment with you if your communication and your actions feel safe, secure, and predictable.

Validation!

Acknowledging their reactions and emotions allows your partner to feel supported and cared for by you. You could try mirroring back parts of what they’ve expressed “I hear you saying you want to be left alone. Do I have that right?” or saying things like “I can’t imagine how hard that must have been for you”.

Trying Your Best Not To Personalise

This is probably one of the hardest ones to master but trying hard to not to take things personally. Your partner may have a distressing reaction, emotional withdrawal, or angry eruption due to a situation. It is important to try to remain calm and remember that they have experienced past relationship traumas, and their reaction may be caused by ‘old stuff’ and not necessarily something you have unintentionally done. Checking in with your partner and being curious and open to their triggers is important.  

Learn, Research and Educate Yourself

Get that internet search bar ready and source some trusted sites educating yourself about c-PTSD so that you feel empowered, confident and prepared. In turn, this may assist you to feel more genuine empathy and patience, (and helps you to not personalise the symptoms as much when they pop up – “oh that’s a c-PTSD thing it’s not directed at me this time!”). Understanding that some behaviours are rooted in trauma can help partners respond easier with empathy rather than frustration.

Clear Honest Reciprocal Communication

Open communication is crucial to any healthy relationship and especially helpful with c-PTSD. Both partners should feel safe to express their feelings and concerns without a worry of judgment or ridicule. Scheduling a regular check-in chat could be a good idea to continue to build trust, safety and intimacy in your relationship. Both partners need to feel supported and validated by each other.

Prioritising Your Self Care

Loving and caring for a partner with any mental health condition is most likely at times going to be challenging and exhausting. It is important to nurture your own mental health and wellbeing as well as your partners. Whilst we ask our partners to care for themselves with their self-care, it is just as important that you care for you too. Ensuring you both have healthy boundaries, having downtime (whatever that looks like for you), ideally incorporating exercise/movement into your weekly routine and spending some time alone and in nature can assist in finding healthy balance and regulation for you.

Seeking Support

Relationships take time, energy and attention to ensure they are healthy and satisfying to both partners. Seeking professional support services and encouraging both personal and couples counselling is recommended. Therapy with a trained professional allows for a structured safe space for learning new skills, healing and growth.

Conclusion

Complex PTSD has the potential to impact our adult romantic relationships even though the traumas most likely were caused a long time ago by difficult childhood relationships. Most of us benefit from protecting and nurturing our own mental health and well-being, and c-PTSD is no different. By focusing on effective communication, educating yourself, ensuring both of you have clear boundaries, prioritising mutual self-care and utilising specialised professional support, the symptoms of c-PTSD can be drastically minimised. With the right support from each other you can both build a satisfying, fulfilling and loving relationship together.

By Carlie Kowald

How to Shift from Criticism to Compassion: Tackling Negative Sentiment Override

Negative sentiment override is a detrimental dynamic that can occur in all types of relationships. Over time, negative sentiment override can cause you to view your partner, your relationship, and the future with your romantic partner in a pessimistic, critical, and negative light. Negative sentiment override is like a biased negative filter whereby one or both partners interpret their partner's actions, intentions, and behaviors in a critical and bleak way.  Fundamentally, it's like having a default setting where your negative perceptions override all the positive ones. 

This can lead to a persistent sense of disappointment, criticism, and difficulty in resolving conflicts. What you used to find cute or quirky about your partner is now read as rude, selfish, or cold. You see not just one or two of their actions in this critical light, you start to see most or sometimes all their actions in the negative sense. In negative sentiment override, even positive gestures or actions from your partner may be judged or interpreted destructively. It can drastically damage the quality of the relationship and make it challenging to feel safety, connection, trust, and intimacy.

Dr. John Gottman is a psychologist and researcher, well known for his lifelong work on relationships and relationship research. In his research, he found that the couples that were in distress were most often the ones in a state of negative sentiment override, and sadly, that unless they could change the negative perspective, that it would statistically be more likely to result in the end of the relationship. 

What Causes Negative Sentiment Override?

It is often the cumulative effect over time of feeling alone, unappreciated, disrespected, unloved, unwanted, and unheard. In therapy, we often find it can be exacerbated by events in the past where emotional safety or trust were damaged, emotional hurt was disregarded and conflicts were not adequately attended to and resolved. 

How Do I Get Out Of Negative Sentiment Override?

When you are in a more positive perspective, your conflicts don’t seem as catastrophic, and you are able to recognise your partner's endearing and appealing attributes. You can view your partner and your relationship in a warmer and more compassionate way.

Turning Towards Each Other

In every relationship we use small, sometimes ambiguous, behaviours as ‘bids for connection’. They are the little ways you can respond to your partner who is trying to engage and connect with you. The tricky thing is they can be so subtle you might miss them if you don’t know what to look for. Bids for your connection can be little gestures like asking about your day, wanting to tell you about a news article, requesting a hug, glancing over at you, asking if you’d like a cup of tea or seeking your advice on a topic.  By accepting their bid for connection and choosing to turn towards them (sometimes literally turning towards them, and sometimes just symbolically), we communicate the message of “You are important to me”, “You matter to me”, “I care about us”. We might put our phone down, turn the TV volume on mute, pause what we’re doing for a few seconds and listen/hug/nod/acknowledge. Just as the bid for your connection can be subtle so can our response. But any response is far more impactful than no response or worse yet a ‘turn away’ or rejection of the bid for connection. As you can imagine, over time these rejected bids for connection cause hurt and can result in a negative sentiment override of the relationship. 

Accepting Influence From Each Other

As discussed in MM’s blog last month, Gottman’s research shows us that partners who can accept influence from each other are far better at managing their conflict and therefore tend to have a more optimistic view of their relationship. Working on compromising, actively and genuinely listening, and having a “we” focus instead of a “me” focus can help you and your partner get out of a negatively filtered relationship perspective. Feeling heard, respected and understood by our partners is one of the best predictors for a relationship that lasts the distance and feels positive, hopeful and rewarding. 

Building Your Love Maps

Love maps represent how much we know about, and feel known by, our partner. Learning about our partner’s dislikes, likes, and their values helps us to create a positive picture of them in our hearts. By understanding what makes them tick, why they like to do certain things a certain way, understanding their inner world and non-judgmentally noticing their quirks or vulnerabilities it helps us to view their behaviours more neutrally and maybe even positively. As well as this, feeling accepted and known by our partner makes us feel more positive and optimistic about our partner and the future of the relationship.

Voice Your Fondness and Admiration

Try to be intentional about holding an overall positive regard for your partner. Consciously trying to see them in a positive light. See their attempts to help the relationship - albeit sometimes frustratingly and humourously misguided. You might choose to share your appreciation for their daily menial tasks, think or journal about your relationship strengths and mini victories, or maybe reminisce together on funny or loving memories about what helped you to fall in love with each other. Voicing and recognising your fondness and admiration for each other assists with a balanced, compassionate, and warm perspective. 

Listen to Truly Hear 

Your partner’s wounds from the past can become their negative biased filter in the present through which they view you and the future of the relationship. Try to gently talk about these past events and ‘relationship wounds’ so that your partner can feel heard and healed. Your partner’s feelings are your focus and truly hearing their vulnerability versus listening with a hyper logical and rational ear will help to heal any hurt. Attempt to accept any responsibility for hurt you may have unwittingly caused in the past, reminding them that while that was not your intention, you can hear how hurt they were. Aim to heal their hurt with your empathy, your non-defensiveness and your care and compassion for them. 

As destructive as negative sentiment override can be for relationships, as you can see with some small behavioural changes, conscious decision making and balanced perspective taking, it truly is possible to turn a negative filter into a warm and compassion viewpoint. As always if you would like to discuss any of these concepts with our MM team please don’t hesitate to reach out. 

By Carlie Kowald. 

Accepting Influence

Most people would agree that an important part of what makes a successful relationship is that both people feel heard and respected by one another. Being open and neutral to our partner’s opinion or perspective is a big part of feeling understood and acknowledged. But let’s be honest here – it can be very challenging to remain open on a topic that we may feel quite strongly about! Partners often feel that they are the ones who are flexible and willing to be equal but it’s their partner who is close-minded and rigid! This may be because it is so hard to ‘accept influence’ on certain topics that may not align with our own thoughts and opinions. 

Accepting influence is not about giving up your own values, needs or opinions, instead it’s about being open to understanding and considering your partner's perspective. By doing so, both partners can move away from unhelpful power struggles and toward a collaborative approach where both can feel heard, respected, and valued. This shift can lead to solutions that benefit both individuals, creating a win-win feeling and fostering a sense of shared power within the relationship. It's about finding common ground and working together toward mutual goals and healthy communication. 

Menial tasks such as how to stack the dishwasher, methods to fold clothes, how often the floors need mopping or who does which chores at home can be easier to be flexible on, although most couples can still butt heads on these topics very rigidly. 

“It’s your way or the highway”

“You never budge on things”

“You do it your way and I’ll do it my way”

“You just redo it your way anyway so why would I bother?”

Budgeting, family holidays, input from in-laws and parenting style strategies are examples of more complex and emotionally based decisions that can see us finding flexibility and accepting our partners influence as much more challenging. 

Successful relationships thrive on a mutual exchange of influence, where both partners feel empowered to express their needs and preferences while also being open to considering the perspective of their partner. This dynamic fosters trust, respect, and a sense of fairness within the relationship. It's a continual process of give and take, with each partner contributing to decision-making and problem-solving in a collaborative manner. Building this pattern of respectful influence can strengthen the bond between partners and create a more fulfilling relationship overall.

Accepting influence from your partner does not mean “yes dear”, “no dear” or fulfilling the attitude of “happy wife happy life”. Accepting influence in a relationship involves recognising the validity of your partner's perspective and being open to the possibility of it influencing your own views and decisions. It's a way of showing respect and value for your partner's opinions, even if they differ from your own. 

Here are some reflective questions to ask yourself about whether you can accept influence from your partner:

1. Self-awareness: Start by examining your own behaviour and attitudes. Are you shutting out your partner's ideas or thoughts? Recognising this in the moment is a powerful step toward change.

2. Listen non-judgmentally: Aim to hear your partner's perspective with genuine curiosity and an openness to understand. 

3. Aim for ways to say "yes": Instead of inadvertently going into a defensive stance, seek opportunities to at least acknowledge your partner's opinion “I see what you’re saying”, “I understand your point”, “I hear why this is important to you”. 

When both partners consciously strive to accept influence from each other, listen with empathy, and seek common ground, decision-making becomes less of a search for power and control, and more of a shared goal. 

This can lead to greater mutual understanding, respect, and satisfaction within the relationship. Remembering to approach conflict with openness and a readiness to negotiate can go a long way toward building a deep and resilient relationship.

Gottman Connect

Take this free quiz and get a sense of how well you and your partner accept influence in your relationship as well as how tuned in to each other you currently are.  

By Carlie Kowald. 

Everything you need to know about Emotion Focused Couples Therapy (EFT)

EFT Explained

Emotionally Focused Therapy (EFT) is a highly effective therapeutic approach that assists couples and individuals navigate through relationship challenges. By following the principles and techniques of EFT, relationship therapists can guide you and your partner towards developing more meaningful, satisfying and rewarding connections together.

Understanding Emotionally Focused Therapy

Emotionally Focused Therapy has been found to be effective in addressing a range of relationship issues, including communication problems, intimacy concerns, infidelity, and unresolved conflicts. It helps couples develop stronger emotional bonds, increase trust and intimacy, and improve overall relationship satisfaction.

Emotionally Focused Therapy was developed by Dr. Sue Johnson and allows couples to review their unique emotional dynamics, foster safe communication, and develop stronger connections. By recognising and addressing the underlying emotions and attachment requirements that impact relationship patterns, individuals can overcome obstacles to intimacy and create more secure and fulfilling relationships.

The Goals of EFT

• Emotional awareness

• Healing attachment wounds

• Identify and challenge unhelpful thoughts

• Trauma processing

• Emotion regulation

How EFT is Applied Within Relationship Counselling

EFT provides a structure for therapists to teach you a series of essential relationship skills:

Reflection: Empathy building skills

Validation: Acknowledging a partner’s emotions and experiences

Re-enactment: Practice EFT skills in session with therapist

Reframing: Form new meaning based on new understanding

By following the principles and techniques of EFT, your relationship therapist will improve emotional connection and build trust and intimacy. The strength of EFT work means that besides reducing conflict, it can also improve your overall relationship satisfaction and therefore longevity.

The Benefits of EFT in Relationships

In summary, EFT offers clear benefits that boost the bond between romantic partners:

• Strengthening the Bond

• Building Secure Attachment

• Resolving Conflict and Repairing Hurt

• Promoting Relationship Satisfaction and Longevity

What to Expect in EFT Sessions

During the initial session of EFT you will feel in safe hands as your therapist will create a safe and non-judgmental space for open communication. They will help guide you both to explore emotions, identify your negative relationship patterns, and understand the underlying attachment need for each of you.

The EFT therapist will help you acknowledge and identify the destructive cycles that may be causing harm to your relationship. Through EFT specific skills and methods, the therapist will assist and guide you to create secure and satisfying connections with your partner.

Taking the First Step Towards a Better Relationship

Even just the thought of seeing a relationship therapist is a daunting decision for some people. Taking the first small step is often the hardest one, but it could be the best decision for a happier more fulfilling future for you individually, as well as your relationship.

Of course change takes some time and effort, but with an EFT therapist in your corner, it can be far easier than you’d ever imagined to feel more connected, appreciated, seen and heard in your relationship.  

By Carlie Kowald

Sources

Johnson, S. (2008). Emotionally focused couple therapy. In A. S. Gurman (Ed.), Clinical handbook of couple therapy (pp. 107–137). Guilford Press.

Emotionally Focused Therapy: 17 Tools for Your EFT Sessions (positivepsychology.com)

Book recommendation:

Hold Me Tight presents Emotionally-Focused Therapy in a nonclinical way that the general public can access. Hold Me Tight: Dr. Sue Johnson, Sandra Burr: 9781491513811: Amazon.com: Books (No affiliation)

Love in the Digital Age: Striking a Balance Between Tech and Togetherness

Technology can get a bad reputation when it comes to relationships. Phone addiction, online cheating, secret dating apps, pornography and feeling second priority from one another can damage the quality of our relationships. According to Dr James Roberts (2016), smart phone users check their smartphones approximately once every six-and-a-half minutes which works out to be roughly 150 times each day. That’s a lot of devotion, obsession and attention dedicated to a small, handheld device!

The term “phubbing” (short for the term “phone-snubbing”) describes those moments we are all too familiar with, when one partner gets distracted once again by their phone and the other partner feels rejected. In fact, phubbing has become so common that it is now one of the more frequent complaints and conflicts we can hear about in romantic relationships.

Much research has been dedicated to these complex topics and in general the studies regularly find that people who report more ‘technoference’ (technology interfering with their communication and quality time with their partners), also reported more conflict on this topic, lower relationship satisfaction, more depressive symptoms, and lower life satisfaction (McDaniel, B. T., & Coyne, S. M., 2016).

Whilst we openly acknowledge the challenges that technology can play in intimacy, we also want to delve into some ways to work with technology and to look at the ways that technology can draw us closer, connect us together and add daily value to our important romantic relationships.

 Instant Messaging and Social Media

Instant Messaging and Social Media platforms such as messaging services and messaging apps allow couples communication to be immediate, instantaneous and in ‘real time’. This allows them to feel connected even when they are separated and physically apart from each other. Instant messaging services can feel less intrusive by allowing a partner to respond when they have the time. Messaging can also allow a couple to be more thoughtful and considered with the wording of a topic, taking the time to choose the right reflections, feelings, and vocabulary. Additionally, video messaging features can be particularly useful for long-distance relationships and can create more personal and interactive communication, helping couples feel more connected throughout the day.

 Organisation and Planning Tools

Organisation and Planning Tools like mutually shared calendars and planning apps help couples coordinate their schedules together, plan activities, and hopefully reduce misunderstandings and conflicting commitments. The shared nature of the visual phone calendar and its ease of accessibility can help to balance expectations of each other and can assist in understanding each other's needs and priorities. The use of a shared calendar requires clear communication and collaboration. Ideally, both partners actively contribute to updating and monitoring the calendar to ensure its effectiveness in improving relationship quality. Finding the balance between adhering to the calendar plans without becoming too rigid as well as allowing for flexibility and spontaneity in the relationship is a good goal to aim for.

 Therapeutic Resources

Therapeutic Resources (such as the very popular telehealth counselling option that we offer at Motivating Marriages), allows access to online counseling services for couples wanting to improve the quality of their relationship. This technology allows for couples to be access treatment at mutually convenient times, in varying locations (enabling couples to engage in therapy together, even if they are in different locations), and in a way that suits their lifestyle (during a child’s naptime or on a lunchbreak). Relationship apps and online resources can offer support and guidance for couples facing challenges. Many online therapy platforms provide follow up resources, such as articles, worksheets, and exercises that clients can access between sessions to enhance their understanding and practice new skills.

 Symbolic Public Gestures

Symbolic Public Gestures such as posting messages, sending emojis, attaching gifs or memes and love hearting a comment are ways that our digital platforms allow us to show and express love and affections even when physically apart from one another. Emojis can add a playful and expressive element to our online communication. We are by no means saying they are a substitute for genuine and open communication in relationships, but they can bridge the gap of connection during a long workday until true re-connection with your partner can occur with a kiss, conversation, hug and debrief. While it’s no balcony scene from Romeo and Juliet; these lighthearted, quick and effective public gestures can provide a sense of support, loyalty and care. It’s a time efficient way to show that you care for your partner.

So, it seems that technology can add value and connectedness in our relationships. Whether it be giggling over a shared meme, swooning over the cute message they sent you on their lunch break, coordinating via calendars what your weekend plans are, swapping funny cat videos or appreciating the small but public ‘liking’ or commenting on your post, technology has the potential to bond us together on shared experiences despite a physical distance.

Respectful and considerate use of phones and technology around your partner is a healthy and recommended ongoing conversation to be had, as this will differ for each person and couple. It's vital for couples to establish healthy communication habits and clear boundaries around technology use. Honest discussions about expectations, privacy, and the role of technology in the relationship will help avoid conflict.

Whilst technology can be used as a tool for effective communication with each other especially when physically apart, it goes without saying that truly connected, deliberate and open conversations are required to maintain the health and satisfaction for all couples and relationships.

So, with that in mind, we suggest you gently pop the phone or tech down for now and go and check in with your romantic partner and enquire about how their day is going, what’s on their mind, and what they are looking forward to in the next few weeks ahead.  It’s all about balance.

By Carlie Kowald

REFRENCES

McDaniel, B. T., & Coyne, S. M. (2016). “Technoference”: The interference of technology in couple relationships and implications for women’s personal and relational well-being. Psychology of Popular Media Culture, 5(1), 85–98.

Dr Robert Roberts (CNN) https://edition.cnn.com/2016/12/14/health/phubbing-phones-relationships/